Systems approach to standardization of care in the secondary prevention of noncardioembolic ischemic stroke

Abstract

A systems approach to stroke care is a multidisciplinary team strategy with the goal of reducing stroke risk. This strategy may start with community-based primary prevention education. For individuals who experience stroke, the inpatient component of a stroke system is designed to integrate evidence-based acute treatment and secondary prevention strategies. A key component to stroke systems care is the use of standardized, evidence-based treatment protocols. During the acute (or subacute) phase of care, the team must be prepared to prevent stroke progression, prevent complications of stroke, manage comorbidities, and reduce the risk of secondary stroke. Hospitalists may take a leadership role both in establishing stroke systems protocols at their institutions and in providing inpatient care for stroke patients. The objective of this article is to review the components of inpatient stroke systems, with a focus on care of patients with noncardioembolic ischemic stroke. Methods to minimize common barriers to establishing stroke systems programs are also presented. Journal of Hospital Medicine 2008;3(4 Suppl):S29-S35. V